Page 11 - Cover Letter and Evaluation for Michael Boucher
P. 11
Client Data Sheet
Client ID: 11419347 April 2, 2021
Please verify the accuracy of the information below and let us know if changes need to
be made.
Client's DOB: 04/15/56
Date that Medicare became or will become primary (when
client has both Part A & Part B): 04/01/21
Client's home zip code: 28212
Has client started receiving Social Security or SSDI payments? No
After client retires, will he or she have access to health
insurance through a spouse's or ex-spouse's employer plan? No
Client travels frequently and wants to get a Medigap policy
Prescription Drugs Client's pharmacy: CVS
Refill Schedule: Monthly
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